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Custom Nursing Research: Problem Statements essay paper sample

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Introduction

Recent years, gerontology research pays a special attention to problems of cardiovascular disease and new methods of their treatment and prevention.

Problem statement

I would like to investigate the problem of cardiovascular diseases among elderly populations and the role of a nurse in this process. The main problem is that long-term case facilities pay no attention to physical activity among elderly and do not introduce new effective programs for this age group (Manheimer, 2008, p. 76).

Problem Analysis

Among the elderly, cardiovascular disease (CVD) is still regarded as the major problem in The USA in terms of prevalence, death rates, the rate of incidence, burden of disease and costs. It has been estimated that 3.7 million people have a long-term CVD and about 1.4 million elderly suffer from a disability associated with the disease. CVD was registered as the major cause of death for 45,670 Elderly in 2006 (34% of all deaths). Coronary heart disease (CHD) was responsible for half of these deaths, and 8,484 of deaths were caused by stroke. More than 78% of people who died of CVD belonged to 74-year-old age group. (The most widely-spread form of CVD, coronary heart disease (CHD), continues to be the major single cause of death and the most common cause of sudden death of Elderly. However, over the past years there has been considerable progress in dealing with CVD in the USA. Improvements in prevention, detection and clinical management of patients suffering from CVD in combination with research brought about the decline in CVD in the USA (Estep III, 2007, p. 51).

In gerontology, CVD diseases are the most costly of all disease groups in the USA. Thus, in 2004-05, total expenditure on CVD diseases was $5.94 billion, which made up 11% of overall health system expenditure. Progress in diagnosis and treatment of heart disease and stroke, emergence of effective medicaments for treatment of high blood pressure and abnormal blood lipid levels, larger numbers of specialists and health-care providers concentrating on CVD, improvements in emergency medical services for heart attack and stroke, and an increase in specialised coronary care and stroke units managed to reduce case death rates and prolongated survival times (Estep III, 2007, p. 51). However, despite of numerous improvements associated with CVD treatment, about 90% of the USA people still have not less than one modifiable risk factor and 16% have more than three risk factors. Many elderly people remain at high risk of CVD because of tobacco smoking, insufficient physical activity, obesity, poor nutrition, psychosocial factors and high levels of blood pressure, cholesterol and alcohol intake. It means that there is a possibility of further declines in CVD death rates in the future (Manheimer, 2008, p. 76).

The impact of physical activity on the prevention and treatment of CVD

Regular physical activity among elderly can give citizens suffering from CVD such benefits as augmented physiological function, reduction in symptoms, enhanced quality of life, improved coronary risk profile, reduced mortality, improved muscle fitness, etc. Although there is much evidence that the impact of physical activity on the prevention and treatment of CVD is great, over the half the USA aged population, including people suffering from CVD, performs insufficient physical activity for health benefit. Insufficient physical activity is associated with almost twice the risk of developing coronary heart disease and, what is more, it brings about a poorer prediction in survivors of myocardial infarction in comparison with that of their active counterparts. According to the recommendations of the Heart Foundation's Expert Working Group, elderly suffering from CVD should perform half an hour or more of moderate intensity physical activity every day (Manheimer, 2008, p. 76).

It is interesting to note that the chances for functional benefit are greatest in those individuals who were least active before starting regular physical activity, and this benefit may be gained even at low levels of physical activity. It is clear that the advantages of regular physical activity far outbalance the risks, with a very low prevalence of injury for walking, gardening and cycling. According to the estimates, the risks of a major or fatal cardiovascular occurrences taking place among participants across the range of CHD attending exercise rehabilitation under supervision are 1 for every 117 000 hours of activity (major occurrence) and 1 per 750 000 hours (lethal event). However, the risk for recurrent cardiovascular events may be increased if the recommended amount of time for exercise is exceeded by the patient (Terry, 2007, p. 64).

New Problem Statement

Analysis of the literature vividly portrays that gerontology should rethink the role of physical activity in long-term care and introduce new programs for this age group (Terry, 2007, p. 64). Many of the elderly people who have experienced heart attacks and strokes are exposed to a high risk of recurrences and death. The research results indicate that the risk of the disease can be substantially lowered when the combination of drugs will be introduced. The use of the cost-effective methods is projected to reduce the risk of the disease among an entire population of the people. The intervention is based on wide interventions many of which are based on the combination of effective policies and broad health promotion policies (Terry, 2007, p. 64).

These conditions should be considered in all settings. In the USA too much focus is being placed on one-on-one interventions among people at medium risk for CVD. The research indicates that a better use of resources might help to eliminate the risk of the disease. The eliminations will be conducted with a careful use of all other resources. The use of these resources is projected to introduce quite a big range of efforts aimed at reducing risk factors through multiple economic and educational policies and programs. The risk factors can be divided into two groups: diet and physical activity. According to the research, the dietary intake of fats, especially their quality, is projected to introduce many changes to the way people are handling the disease. First of all, the measure is projected to influence the risk of CVD like coronary heart disease and stroke (Wilson and Narayan, 2008, p. 508).

In addition, the following measures can reduce the effect of CVD

  • Limitation of energy intake from total fats. The objective can result in shifting fat consumption away from saturated fats to unsaturated fats. The main objective of the measure is to eliminate trans-fatty acids;
  • Increasing consumption of omega-3 fatty acids. These are usually exterminated from fish oil or plant sources;
  • Consuming a diet high in fruits vegetables, nuts and whole grains. The level of these things is rather low in refined grains.
  • Avoiding excessively salty or sugary foods.
  • Avoiding smoking
  • Maintaining a healthy weight.
  • Introducing effective interventions

While searching for the strategies and interventions that are relevant to the given heath care issue one should pay to the examples of the following states. United Kingdom is known for introducing a government-promoted program. Korea is one more country that has been involved in the issue. The combination of society and government initiatives is projected to introduce many changes to the society. The combination of these things have led to launching the mass media campaigns that main objective of which was to promote local foods and traditional cooking methods. Japan is the country that is known for introducing a large number of government-led health campaigns.

Finland is known for introducing community-based and national interventions. The major part of these interventions is projected to sustain both health promotion and nutrition interventions. When combined together these factors may lead to population-wide reductions in cholesterol and other risks. The event was followed by the large decline in coronary heart disease deaths. The combinations of these things led many companies to the fact that many of them decided to reformulate their products.

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